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Contact Information

BLUE RIDGE ACADEMIC MEDICAL GROUP, PLC
3700 S MAIN ST
BLACKSBURG, VA24060-7017
 Phone: 540-951-1111
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neuromusculoskeletal Medicine, Sports Medicine

204C00000X 12 Physician/Osteopathic Manipulative Medicine
Indicates primary specialty

NPI Profile & details for BLUE RIDGE ACADEMIC MEDICAL GROUP PLC · (Female)

NPI Number 1861453078
Status Active
Credentials
Entity Individual
Enumeration date 03/29/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • VA License # 0102201473
  • VA Other 279560 ANTHEM
  • VA Other DA5070 RAILROAD MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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